We Need to Talk About Adults and the Flu Shot – Bethany Stoller

I drive past the main campus of the Centers for Disease Control and Prevention almost every day. The shops and restaurants across the street are always bustling with everyone from interns to to divisional directors. But sometimes there are also protesters.

The protesters typically hold signs saying that vaccines harm children, that CDC has not taken safety precautions, and similar false conspiracy beliefs.

While misinformation about childhood vaccines has been the focus of much cultural discourse, less has been said about American adults’ ongoing reluctance to get an annual flu vaccine.

According to a CDC report published last September, an estimated 45.3% of adults in the United States received a flu shot in the 2018–19 season. That’s up almost 9% from the previous year, but it’s still significantly below the Healthy People 2020 target of 80% to 90% coverage for low- and high-risk groups respectively.

Despite the lack of vaccine coverage, there is surprisingly little scholarship deciphering the reasons adults go unvaccinated.

As a public health student, I spend every day around people who are knowledgeable about the benefits of vaccines. Despite that, many of my friends and classmates haven’t been vaccinated this year. Some of them even argue they’ve come down with the flu after getting the vaccine in previous years. This line of reasoning usually begins with the phrase “I believe in vaccines, but…” followed by reasons they don’t feel motivated to get the flu shot.

One of the few studies looking at this issue asked adults who had no intention to be vaccinated why they did not vaccinate. The two most common responses were that they did not believe in the flu shot and that they did not need the flu shot.

While those may seem similar on a superficial level, that result suggests that some adults believe that the flu shot is generally beneficial but either feel that it won’t protect them or that they don’t need to be protected against the flu. Like my friends, it’s not that they are anti-vaxxers, it’s just that they don’t believe they’ll personally benefit from vaccination.

Though I know they’re wrong, I’m not in a position to be casting stones on this issue, since I put off getting my flu shot until Christmas Eve — even though I intended to get it early in the season. I believed I should be vaccinated and would be able to get the vaccine for free, but I never got around to it until Christmas break.

My experience is a common one. The same study mentioned above found that the most common reason adults who intend to be vaccinated fail to do so is that they “didn’t get around to being vaccinated.” For this group, they believe they’ll benefit from a vaccine, but it doesn’t seem urgent enough to be a priority.

Vaccinating more low-risk adults is crucial for protecting high-risk adults as well as children. These two reasons for adults not to get the flu vaccine suggest that public health officials need to do a better job of communicating both the benefits and the time-sensitivity of vaccination. Moving forward, we as a field should be careful to consider ways of making vaccination a priority for low-risk adults.

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